Your gallbladder is vital for digesting fats and absorbing fat-soluble vitamins, including vitamin D. Whether you have your gallbladder or no gallbladder, it is important to know you may be at risk for Vitamin D deficiency. Lets discuss why and the connection with gallbladder issues. 

When your gallbladder isn’t working right, or if you’ve had it removed, your body might not release enough bile. Bile helps break down fats so your body can absorb nutrients like vitamin D. Inadequate bile can lead to low vitamin D, resulting in symptoms like fatigue and bone pain.

If you’re facing gallbladder issues or Vitamin D deficiency, a targeted diet and lifestyle can make a huge difference. In this blog, you will learn more about improving gallbladder health and how to improve your vitamin D levels through targeted integrative nutrition.

Key Takeaways

• Vitamin D deficiency is common with gallbladder and liver issues.
• Lack of bile can hinder the absorption of vitamin D.
• Proper diet and lifestyle changes can improve gallbladder health and vitamin D levels.

Understanding Vitamin D and Its Importance

Understanding the role of vitamin D in your body is essential, especially when dealing with gallbladder issues. This section covers the main functions of vitamin D, how your body makes it, where it comes from, and what happens when you don’t get enough.

Roles of Vitamin D in the Body

Vitamin D is required for many bodily functions.

• Absorbs calcium and phosphorus from the intestines: Vital for bone health and mineralization[i]. Without enough vitamin D, your bones can become weak and prone to fractures. 
• Supports your immune system[ii].
• Reduces inflammation.
• Promotes gut health[iii].
• Plays a role in muscle function[iv]. Lack of vitamin D can lead to muscle weakness and pain. These symptoms can be particularly troubling if you already have gallbladder problems, making it even more important to maintain proper vitamin D levels.
• Regulates cellular functions.

Vitamin D Synthesis and Activation[v]

Vitamin D synthesis begins in your skin. When exposed to sunlight, your skin converts a form of cholesterol into vitamin D.  It travels to the liver, where it becomes 25-hydroxyvitamin D, an inactive form that some doctors measure to check for deficiency.

Next, the 25-hydroxyvitamin D is converted to calcitriol in the kidneys and some immune cells.  Calcitriol has a half-life of only a few hours, and it circulates in the body as a hormone[vi].  (The blood test for this form of Vitamin D3 is the 1,25-dihydroxycholecalciferol test or the 1,25(OH)2 test.)

Finally, calcitriol is activated by enzymes in the Cytochrome P450 family, allowing it to bind to the Vitamin D receptors found on almost all cells[vii].

The liver is crucial in this process. If you have liver issues, your body might not be able to convert vitamin D efficiently. (This is why both liver and gallbladder health are essential for maintaining good vitamin D levels.)

Sources and Forms of Vitamin D

There are two main forms of vitamin D: vitamin D2 and vitamin D3.  Vitamin D2 is found in some plants and fortified foods.  Vitamin D3 comes from animal products like fatty fish and is also produced when your skin is exposed to sunlight or UV lamps. 

Supplementation can be another way to get vitamin D, but for reasons I’ll cover later in this article, supplements alone are not enough. 

Symptoms of Vitamin D Deficiency

Low vitamin D can cause various symptoms. The most common include muscle pain, weakness, and bone pain. You might also experience a “pins and needles” sensation in your hands or feet. For those who’ve had gallbladder surgery (cholecystectomy), these symptoms can be more pronounced.

Other signs to watch for are frequent infections, fatigue, and even mood changes. Long-term deficiency can lead to more severe problems like bone fractures and skeletal deformities. 

Why Vitamin D Deficiency is Common WITH a Gallbladder

Vitamin D deficiency is more common than you might think, even if you still have your gallbladder. This can be due to factors like lack of sun exposure, certain bowel diseases, past digestive surgeries, some medications, and your genetic makeup.

Lack of Sun Exposure

One major reason for vitamin D deficiency is not getting enough sun. Your skin makes vitamin D when it’s exposed to sunlight. Barriers to sunlight exposure like living in areas with limited sunlight or having a job that keeps you inside can lead to low levels of this important vitamin.

It should be noted that sunscreen can interfere with vitamin D production. If you hardly spend time outdoors without sunscreen, it might be challenging for your body to make enough vitamin D.

Inflammatory Bowel Diseases

Inflammatory bowel diseases (IBD) like Crohn’s disease or celiac disease can result in low vitamin D[viii]. These diseases make it hard for your body to absorb nutrients properly.

The inflammation caused by IBD affects the gut, which is crucial for absorbing fat-soluble vitamins like vitamin D. This means you might not get the vitamin D you need from the food you eat. Taking care of your gut health can help improve vitamin D absorption.

Digestive System Surgeries

Surgeries on the digestive system can also impact how your body absorbs vitamin D[ix]. Procedures like bariatric surgery and other gut surgeries might alter the sections of your intestines responsible for nutrient absorption.

When these critical sections are removed or bypassed, it can lead to lower levels of 25-hydroxyvitamin D, which is the main (although inactive) form of vitamin D circulating in your blood. Monitoring your vitamin D levels after such surgeries is essential.

Certain Medications

Certain medications can interfere with vitamin D amounts in your body. For example, anticonvulsants, used to treat epilepsy, can cause your liver to break down vitamin D faster, leading to a deficiency.

Other drugs, like some steroids, can reduce the effectiveness of vitamin D in your body. Always check with your doctor if you’re taking medications and are concerned about your vitamin D. 

Genetic Variations

Genetic variations, called “single nucleotide polymorphisms” or “SNP’s” can alter vitamin D metabolism.  SNPs effect one nucleotide of a genome and are the most common type of genetic mutation. Some SNPs impact vitamin D synthesis, conversion, or activation directly, and some SNPs effect it indirectly via changes to other processes or metabolites[x].  

For example, SNPs can alter the function of enzymes in the body.  CYP2R1 is an enzyme made in the endoplasmic reticulum of liver cells and is necessary to perform the first step in vitamin D activation.  CYP27A1 is most prominently involved in bile acid synthesis and is thus, necessary for the breakdown of fats and fat-soluble vitamins. A recent study found over 35 genes associated with vitamin D deficiency[xi]!

Why Vitamin D Deficiency is Common WITHOUT a Gallbladder

As you’ve seen above, vitamin D deficiency can be common if you still have your gallbladder.  Living without a gallbladder puts you even more at risk for vitamin D deficiency due to changes in bile production and absorption of essential nutrients. This affects how your body handles fat-soluble vitamins, potentially leading to other health concerns.

Bile Production and Its Necessity for Digestion

The gallbladder stores bile, a digestive fluid produced by the liver. Bile helps break down fats so your body can absorb fat-soluble vitamins like A, D, E, and K. Without the gallbladder, bile is released directly from the liver into the small intestine. This process is less efficient, making it harder for your body to digest fats[xii].

Impaired Absorption of Fat-Soluble Vitamins

With impaired digestion, you might struggle to absorb fat-soluble vitamins. These vitamins get dissolved in fats, so when fat digestion is compromised, vitamins like D and K2 aren’t absorbed well. Digestive disruption can also impact your overall nutrient intake, affecting your health over time. This can lead to deficiencies, causing symptoms like fatigue, bone weakness, and easy bruising. 

Gall Bladder Removal Leads to Fatty Liver

When you don’t have a gallbladder, fat can accumulate in the liver, a condition called non-alcoholic fatty liver disease (NAFLD). Fatty liver hampers bile production and fat metabolism, further contributing to vitamin D deficiency and other healthcare issues[xiii]. As a fatty, sluggish liver becomes more toxic, it becomes increasingly less efficient at metabolizing and activating hormones.

Gut-Liver Axis & Leaky Gut

The gut-liver axis describes the relationship between your digestive tract and liver. Gallbladder removal disrupts this axis, potentially causing leaky gut syndrome—where the intestinal lining becomes more permeable[xiv]. This can lead to poor nutrient absorption, including vitamins D and K2. A disrupted gut microbiome and increased intestinal permeability may also exacerbate inflammation and nutrient deficiencies[xv].

What Needs to be Fixed to Improve Vitamin D Levels?

Improving vitamin D levels requires attention to different aspects of your health. Addressing issues related to digestion, the gut-liver axis, and your relationship with the sun are crucial steps.

Digestion

If your digestive system isn’t working well, it can’t effectively absorb nutrients from food. Taking steps to improve your digestion can help.

• Eat a diet rich in organic, whole foods
• Avoid processed, sugary, and prepared foods
• Avoid inflammatory industrial seed oils
• Avoid artificial sweeteners and fructose
• Incorporate foods and herbs that support digestion, the liver, and bile health (i.e.: milk thistle, curcumin, schisandra, artichoke, burdock root, dandelion root, etc.)
• Consider digestive enzymes, bile salts, and/or digestive bitters

Gut-Liver Axis

The gut-liver axis refers to the connection between your digestive tract and liver. A healthy liver is necessary for vitamin D metabolism. If you have problems like fatty liver, it can negatively affect serum vitamin D levels.

Conversely, when your gut microbiome is out of balance, it can impact liver function. This imbalance may occur due to poor diet, antibiotic use, or unhealthy lifestyle choices. Maintaining a healthy gut microbiome through diet can improve your overall vitamin D levels[xvi].

Some tips to support a healthy microbiome and gut-liver axis include:

• Address any gut issues such as food sensitivities, leaky gut, parasites, etc.
• Eat fiber-rich foods
• Incorporate fermented foods into your diet
• Use an organic castor oil pack around your right upper abdomen
• Obtain appropriate exercise
• Take CDP choline to break down fatty deposits in the liver
• TUDCA supplementation[xvii] to support gallbladder health, fat metabolism, bile flow, healthy gut microbiome, and more.
• Promote regular bowel movements

Relationship to the Sun

Sun exposure is one of the most natural ways to boost vitamin D measurements[xviii]. Your skin synthesizes vitamin D when it’s exposed to sunlight. However, too much sun can lead to skin damage, so finding a balance is key.

Spending about 10-30 minutes in the sun without burning a few times a week can help maintain adequate vitamin D[xix]. The exact time needed can vary based on your skin type, age, location, and time of year.

If you live in areas with limited sunlight, especially during winter, you may need to rely on vitamin D-rich foods or supplements. Foods like fatty fish, fortified dairy products, and egg yolks are sources of vitamin D[xx].

Focusing on these areas can help you boost your vitamin D, supporting both your overall health and specific needs related to your gallbladder.

Why Won’t Supplementation Fix Vitamin D Levels?

Taking vitamin D supplements sounds simple, but it doesn’t always solve low vitamin D. This can be due to issues like trouble digesting fats, having a fatty liver, or problems in your gut.

Doesn’t Provide Enzymes to Digest Fats

Vitamin D supplements don’t provide the enzymes needed to digest fats.  Dumping more Vitamin D into a system that’s already struggling to digest the fats and fat-soluble vitamins it has simply compounds the problem.  

Doesn’t Fix Fatty Liver

A fatty liver can interfere with how your body processes and stores vitamin D. When your liver is busy dealing with excess fat, it can’t convert and use vitamin D effectively. This means that even with supplementation, your vitamin D measurements might not improve.

Taking care of your liver health is imperative. Reducing the amount of fat in your liver can help improve how your body handles vitamin D. This often means changing your diet and lifestyle to support better liver function.

Doesn’t Fix Leaky Gut

Vitamin D supplementation doesn’t fix the root causes of intestinal permeability.  Further, when your gut lining is damaged, it’s harder for your body to take in what it needs from supplements.  Addressing a leaky gut might involve dietary changes, probiotics, and other options to optimize gut health. 

Conclusion

Vitamin D deficiency goes hand-in-hand with gallbladder issues, and both must be addressed.  As an Integrative Nutritionist, I help people recover from gallbladder surgery and optimize their health.  I invite you to get started and join my Gallbladder Saver Society Membership!